Implementation of the ABCDEF Bundle in an Academic Medical Center

Objective: To describe the highlights of our medical center's implementation of the Society of Critical Care Medicine's ABCDEF bundle in 3 medical intensive care units (ICUs). Methods: After a review of our current clinical practices and written clinical guidelines, we evaluated deficiencies in clinical care and employed a variety of educational and clinical change interventions for each element of the bundle. We utilized an interdisciplinary team approach to facilitate the change process. Results: As a result of our efforts, improvement in the accuracy of assessments of pain, agitation, and delirium across all clinical disciplines and improved adherence to clinical practice guidelines, protocols, and instruments for all bundle elements was seen. These changes have been sustained following completion of the data collection phase of the project. Conclusion: ICU care is a team effort. As a result of participation in this initiative, there has been an increased awareness of the bundle elements, improved collaboration among team members, and increased patient and family communication.